In general, surgeons should operate on diabetic patients as early in the morning as possible.
A patient on Lantus or NPH insulin should take 80% of the dose the night before.
Bowel prep patients should receive 1/2 of the AM and PM insulin doses throughout the duration of the bowel prep. They should monitor their glucose levels vigilantly and replenish with clear liquid glucose as necessary
No solid food after midnight prior to surgery.
Clear liquid until 6 hours prior to surgery (both AM and PM cases). Jello, apple juice, clear soda, clear broth, and tea
Patient arrives in surgery holding area at 0600 or 2 hours prior to AM surgery.
Patient arrives in surgery holding area 4 hours prior to PM surgery.
Patient holds all insulin and oral hypoglycemic on the day of surgery.
Upon arrival of the patient, the PACU nurse
Performs checmistix and notifies anesthesiologist of result above 200 mg/dl or below 80 mg/dl
Starts IV DVLR at 125ml/hr rate. For patient age 8 or under, consult anesthesiologist
Administers NPH insulin subcutaneously 1/2 of total AM dose regardless of type of insulin patient is on.
PACU nurse performs postop chemstix. Notify anesthesiologist of result above 200 mg/dl or below 80 mg/dl
If a patient if hypoglycemic (chemstix < 80) while NPO prior to coming to the hospital they can take clear liquids such as apple juice.
This page has been edited 2 times. The last modification was made by - s24man on Jan 7, 2010 10:49 am
This page has been edited 2 times. The last modification was made by -